Anxiety, Depression And Related Factors Among Medical Undergraduates: A One-year Longitudinal Study

ObjectivesThis study aims to assess the prevalence of psychological symptoms (anxiety,depression) and its longitudinal development among medical students; to examine thecharacteristics of anxiety and depression on different grades, gender, etc; to find thepossible relationships between psychological symptoms and related factors, such asfamily function, social support, negative life events and quality of life; to provideevidence for early intervention of mental health.MethodsA sample of10340medical undergraduates from the First and Second grade amongthree medical universities of Anhui Province participated in the longitudinal study forone year, with an interval of6months. Data were collected by using a structuredquestionnaire, which included the Beck Depression Inventory, Beck Anxiety Inventory,Social Support Rating Scale, Life Events Scale, Quality of Life Scale, and FamilyAPGAR Index.Multivariable ordinal logistic regression were employed to explore influentialfactors of anxiety and depression; the dependent variables were anxiety classificationand depression classification, respectively; the independent variables were negative lifeevents, family function, quality of life, social support, and the demographiccharacteristics, such as gender, age, grade, et al. Furthermore, generalized estimating equations (GEEs) and hierarchical linear modeling (HLM) were used to evaluate thecorrelation between psychological symptoms and related factors, such as familyfunction, social support, negative life events and quality of life.We set up the quantitative database using EpiData3.1after checking and codingquestionnaires. The database was analyzed using SPSS17.0and HLM6.08.Chi-squared test (or Fisher’s exact test), one-way ANOVA, rank correlation,multivariable ordinal logistic regression analysis, GEEs and HLM were used foranalysis in the study. In all tests, the level of significance was set up at P<0.05.ResultsPrevalences of anxiety and depression:16.8%,14.7%,10.3%of the medical students suffered from depression and14.1%,14.3%,9.0%from anxiety in the first, second and third investigation respectively.Results of Chi-squared test indicated that there were significant differences ofdepression and anxiety in different time point.Characteristics of psychological symptoms on grade and gender:Female students were more likely to have anxiety, the second-year students hadhigher levels of psychological symptoms than the first-year students in different timepoint. Female students were more likely to have depression in the first and secondinvestigation, while male students were more likely to have depression in the thirdinvestigation.Relationship between psychological symptoms and family factors:Poor household incomes were associated with more depression and anxiety. Medicalstudents from non-intact family were more likely to have anxiety in the second investigation.Relationship between psychological symptoms and satisfaction of specialty:Satisfaction of specialty was one of the predictors of depression and anxietysymptoms among the medical students. The students who were dissatisfied with theirspecialties were more likely to report depressed and anxious symptoms.Relationships among depression, anxiety, family function, social support, negativelife events and quality of life:Social support, family function and quality of life were significant negativelyassociated with depression and anxiety symptoms. Negative life events were significantpositively associated with depression and anxiety symptoms.Multivariable ordinal logistic regression:Multivariable ordinal logistic regression revealed that quality of life, negative lifeevents, social support, family function, etc entered regression equation. Students whohad severely negative life events, poor quality of life, less social support or familydysfunction were more vulnerable to anxiety and depression symptoms.Generalized estimating equations and Hierarchical linear modeling:Female, the second-year students, dissatisfaction of specialty, social support(objective support, utilizations of support), family function, negative life events, andquality of life were the significant predictors of depression and anxiety symptomsamong the medical students.ConclusionsDepression and anxiety symptoms were relatively prevalent among medical studentsin Anhui Province, and multiple factors could affect depression and anxiety. There are significant differences of depression and anxiety in gender. The second-year studentshad higher levels of psychological symptoms. Poor household incomes were associatedwith more depression and anxiety. The students who were dissatisfied with theirspecialties were more likely to report depressed and anxious symptoms.Depression and anxiety among medical students were significant associated withfamily function, social support, negative life events and quality of life. Supportive socialrelationships can play an important role in relieving the stresses and improving theirpsychological well-being among medical students. Negative life events possibly play animportant role in occurrence of anxiety and depression.To promote the students’ healthy development, we should pay more attention topsychological symptoms, and carry out kinds of preventive measures to decrease theincidence of anxiety and depression symptoms.